Bangladesh Succeeds With Family Planning

Published: October 6, 1994

Sterilization is not the Government's chief method of population control, accounting for only one-fifth of contraception in 1993-94, down from one-third in 1983. The growth in contraceptive use (from 19.1 percent to 45.1 percent) in a decade is attributable to oral pills (about 40 percent of all contraception). The family planning program provides access to essential services, increasingly through nonprofit groups; services for which 24 percent of married women still have an unmet need.

Ms. Hartmann's observations about payment of fees to doctors and other family planning workers for sterilizations are out of date. These fees were abolished more than four years ago on the advice of the World Bank-headed donor consortium.

The primary health care services in Bangladesh need much improvement, but we cannot blame the family planning program for their problems. Considerable resources have been invested in building primary health care infrastructure in rural Bangladesh, but it takes time to reach 115 million people. The budget for family planning is in addition to and not part of the health budget.

With a flood- and storm-ravaged land mass about the size of Wisconsin, a population density of nearly 800 people per square kilometer and an annual per capita gross national product of around $220, Bangladesh has every reason to be concerned about population growth. Other related areas of development, however, such as education of women, employment opportunities for women and increased access to primary health care, are not being neglected.

Family planning in Bangladesh is a success story. A reduction of the average number of children from more than seven to fewer than four per woman in less than 20 years, in the face of severe socioeconomic constraints, is no mean achievement. PASTOR B. SISON Public Affairs Consultant for South Asia, World Bank Washington, Sept. 30, 1994